Individual
LISA RENEE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP, BC
Contact information
Practice address
1095 LIBERTY ST NE, SALEM, OR 97301-1137
(503) 581-6550
(503) 581-4755
Mailing address
1095 LIBERTY ST NE, SALEM, OR 97301-1137
(503) 581-6550
(503) 581-4755
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201607001NP-PP
OR
Other
Enumeration date
04/09/2014
Last updated
09/30/2016
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